Why Home Evaluations?
Top Five Factors for Conducting Home Evaluations in 2021
About the Author:
Carolyn Sithong MS, OTR/L, SCEM, CAPS
Founder & President
Home for Life Design®
Jan 12, 2021 - Charlotte, NC
In November 2019, The Wall Street Journal had reported “Aging in Place Positioned to ‘Upend’ Senior Housing.” Unknowingly only a few months later, Covid-19 further compounded the need of aging and disabled populations to remain safe at home. The elderly and those with chronic conditions have been more likely to be affected by the virus while stay-in-place mandates have exacerbated feelings of anxiety and isolation among households.
A “Home” in 2021 has become a more powerful concept. A place of choice, safety, and decreased risk in a post Covid world. As people seek out ways to remain at home as an alternative to expensive long-term care, home eval services can offer strategies and solutions to do so effectively.
1) Ten-Thousand baby boomers turn 65 every single day, and this trend will continue into the 2030s
Every minute, nearly seven baby boomers turn 65, according to the AARP (US Census Bureau, 2020). In addition, AARP found in their Home and Community Reference study, that over 77% of these individuals desire to age in place (AARP, 2018). Home assessment practice is in critical need and demand amongst this rapidly growing population. Performing home safety assessments and providing possible solutions to make homes safer and more functional for the long term are proven steps to help reduce healthcare costs, prevent falls, and increase quality of life.
2) Long-term care costs continue to rise at a “staggering” rate (Genworth Financial, 2018).
By offering a home safety assessment, qualified aging in place professionals can identify and eliminate barriers in the home. Simple recommendations such as grab bar placement, adaptive equipment, modified showers etc could be the basic support the client needs to remain at home. Watch how the placement of grab bars impacts function and safety in the bathroom. In addition, these low-cost home modifications are a clear alternative when compared to the average yearly costs of assisting living ranging from $48,000-$100,000 (Genworth Financial, 2019). The home assessment further supports decision making for family members and caregivers who want to honor the choice of loved ones who wish to remain at home.
3) Home evaluation practice is also relevant among children with special needs as they age and transition into the community.
Therapy practices that service children and young adults with special needs such as Intellectual Disability Disorder or Autism benefit from home safety assessments as well. The growing prevalence of Autism, diagnosed in 1 out of 54 children in 2020, necessitates a closer look at how this population will age at home and live in community (Centers for Disease Control, 2020). Parents need choices and solutions for how to care for their child as they grow and develop. Home safety solutions and features can support the child as they age and transition to adulthood.
4) Home evaluation practice is a shared intervention provided by both OT and PT
PTs & OTs overlap many practices because they share the same goal: function and independence. What commonly separates these disciplines is the therapeutic intervention that gets them to end goals and the theoretical underpinnings each profession brings to the therapy process. To third party payers, both therapies play an important role and often bill the same therapy codes. Conducting home assessments is a shared best practice for both OT and PT. It helps uncover important surrounding aspects of the client and solves a population health issue by creating healthy communities that are accessible and functional, one home at a time. Whichever practice is in the home, they should initiate this important piece of evaluation for the client.
5. Performance-based home evaluations can facilitate clinical reasoning and provide opportunity for skilled therapy, billable to insurance
A performance-based home evaluation, unlike a checklist, involves the client performing and interacting with objects throughout the home. An assessment, detects areas where safety is a concern, or function is compromised. As the therapist explains and crucially analyzes the dysfunction observed during the assessment, they can make suggestions to modify the task or the environment for the client.
If the environment is modified with adaptive equipment, assistive technology etc., it is important to conduct a follow up assessment. This visit can include but not be limited to, training by the clinician on this new equipment to establish new habits, or education on its proper use. Both examples require additional skilled interventions. Offering solutions combined with self-care and home management training on installed solutions, makes this practice a skilled and billable service under Medicare.
Inadequate US housing stocks and ever-increasing senior housing costs are forcing aging populations to seek other options. Covid-19 even further hastened the need for better solutions for these vulnerable populations.
Home assessments have become a clear alternative to expensive, risky, facility placement. Home assessment practice has become an essential service for the foreseeable future.
PT & OT practice have unique opportunities to solve this very real problem. Many can benefit from an OT or PTs professional diagnosis of the home and learn effective ways to create accessibility and safety for the long term.
Grant, Peter (Nov 2019). Boomers Want to Stay Home. Senior Housing Now Faces Budding Glut. Wall Street Journal. https://www.wsj.com/articles/boomers-want-to-stay-home-senior-housing-now-faces-a-budding-glut-11573554601
Binette, J. and Vasold, K. (2018). 2018 Home and Community preferences: A national survey of adults
Centers for Disease Control. (2020, September, 25). Data and statistics on Autism Spectrum Disorder.
Freedman, V. & Spillman, B. (2014). The residential continuum from home to nursing home; Size,
characteristics and unmet needs of older adults. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 69(7), S42-S50.
Genworth. (2018, October 16). Genworth's 15th Annual Cost of Care Survey Shows Continuing Rise in Long Term Care Costs. https://newsroom.genworth.com/2018-10-16-Genworths-15th-Annual-Cost-of-Care-Survey-Shows-Continuing-Rise-in-Long-Term-Care-Costs
United States Census Bureau. (2018, December, 10). 2020 Census will help policymakers prepare for the incoming wave of aging boomers. https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html